Individual
WELLEY WALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RT/MT
Contact information
Practice address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440
Mailing address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
243600
NY
2471M2300X
Mammography Radiologic Technologist
—
NY
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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